TMS therapy is gaining recognition as an effective treatment for depression, but researchers believe it can also treat other mental health conditions. This includes borderline personality disorder (BPD).
When BPD appears, it often does so in early adulthood, creeping up as a pattern of:
- Extreme or unregulated emotions and thoughts
- Impulsive acts or reckless behavior
- Unstable relationships
- Fear and/or intolerance of being alone
Other symptoms of BPD include:
- Shifts in your opinion of yourself that happen quickly
- Losing contact with reality
- Intense anger
- Strong mood swings
BPD is such a serious mental illness because self-harm and suicide are both common. Over three-quarters of BPD sufferers engage in self-harming behavior. Almost 80% have attempted suicide, and 8% to 10% die by suicide.
Around 5.9% of adults (14 million Americans) have BPD at some point in their lives. The mental health disorder also occurs alongside other mental health issues. Common co-occurring conditions include:
It’s for this reason that BPD is often misdiagnosed. Psychiatrists usually mistake the condition for major depressive disorder or bipolar disorder. This ends up delaying or preventing recovery.
BPD, like depression and bipolar, involves mood instability. But with BPD, your mood changes over a short period of time. These changes can happen within the span of a day, while those of bipolar can last for weeks or months at a time.
TMS Therapy for BPD
Many BPD patients also suffer from depression. Researchers wanted to see if TMS treatment would reduce depression in BPD patients. One randomized study involved 20 BPD patients experiencing depressive episodes. Researchers gave the participants 15 days of TMS therapy and then 15 days of sham TMS therapy, or vice versa. They found that TMS therapy reduced the symptoms of depression. Results were measured using the Hamilton Depression Rating Scale (HAM-D).
How TMS Therapy Works in the Treatment of BPD
TMS therapy is a treatment that targets certain brain regions with magnetic pulses. This brings affected brain regions back to a normal level of activity. In conditions like depression and anxiety, the amygdala, which processes emotions, becomes overactive.
Brain scans show that BPD patients have small amygdalas. The smaller this brain region is, the more active it is. People with BPD also have prefrontal cortexes that are inactive. The prefrontal cortex allows you to reason. These differences help explain why BPD patients are prone to impulsivity and depression.
Brain-imaging studies suggest TMS therapy could treat not only the depressive symptoms of some BPD patients but their BPD symptoms as well. Previous research has found that rTMS can reduce the severity of BPD symptoms.
Traditional BPD Treatments
The FDA hasn’t approved a specific medication for the treatment of BPD. It has approved medication for the treatment of depression, as well as TMS treatment for depression. Still, psychiatrists do recommend various medications to help BPD. These help patients to manage their core symptoms, as well as co-occurring conditions. Medications include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Mood stabilizers
- Antipsychotic drugs
These drugs can help treat specific aspects of BPD, including core symptoms like:
- Mood changes
- Cognitive issues
A few different types of therapy can help BPD patients:
- Overcome emotional problems
- Build healthier relationships
- Learn how to understand themselves
Common approaches include:
Dialectical Behavioral Therapy (DBT)
This talk therapy was designed specifically to treat of BPD. Like cognitive behavioral therapy, it focuses on changing unhelpful ways of thinking and behaving, but it revolves around the hypothesis “that the disorder is a consequence of an emotionally vulnerable individual growing up” in an “invalidating environment.” This is an environment where a child’s emotions and responses are invalidated by the people around him or her. He or she is also expected to be self-controlled and self-reliant.
DBT has four modes of treatment and emphasizes the importance of the relationship between the patient and the therapist:
- One-on-one therapy
- Group skills training
- Telephone contact with therapist
- Consultation with therapist
Cognitive Behavioral Therapy (CBT)
This focuses on the idea that thoughts, feelings, and behaviors are all connected. CBT allows patients to see how thoughts lead to certain feelings and behaviors. The aim is to help you take control of how you respond to your thoughts and feelings.
For many individuals with BPD, medication and therapy manage their symptoms. But these treatment options don’t work for every patient. If your borderline personality disorder resists treatment or you can’t tolerate the side effects of medications, don’t lose hope! Consider an alternative route. For many BPD patients, TMS therapy offers relief from living with BPD when other options fail.